How migraines can affect your child

Studies show that children with migraines have a higher risk for depressive disorders, anxiety, and behaviors such as hyperactivity and attention problems. (Jupiterimages)

Think migraine , and more than likely you envision an adult problem. But kids get migraines too, and these serious headaches may be linked in some way to behavior disorders in children.

One recent study on children and migraine headaches, published in the journal Cephalagia and involving 1,856 kids from ages 5 to 11, found that children with migraine headaches had a significantly higher risk for behavior disorders. The finding is in line with results from previous studies showing that children with migraines have a higher risk for depressive disorders , anxiety, and behaviors such as hyperactivity and attention problems .

Behavior problems could be a trigger for migraine attacks in children, or they could be a result of migraines. "It is hard to tease out the link between problems like depression and hyperactivity from migraine because all these conditions are common in children," says Andrew D. Hershey, MD, PhD, associate director of neurology research and professor of pediatrics at Cincinnati Children's Hospital in Ohio. "Both behavior problems and headaches need to be checked out. The most important thing to realize is that children do get migraines. In fact, migraines are one of the top five childhood disorders, even more common than childhood asthma ."

Migraines can start at any age. Before age 7, they are more common in boys. After puberty, they are more common in girls.

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RECOGNIZING MIGRAINE IN CHILDREN

"Headaches in children that come and go are often blamed on sinus or allergy problems," says Dr. Hershey. "We now know that these headaches are much more likely to be due to migraines." Symptoms to look for include:

- A pounding type of headache — younger children may have pain on both sides of the head or across the forehead - Pain that limits the child's activity or is made worse by activity - Pain that is moderate to severe (most migraines are more moderate than severe) - A headache that lasts from one to 72 hours - A headache that comes with nausea or vomiting - A headache that's made worse by sound or light

Very young children who can't complain of pain may become quiet, pale, and sweaty. Children may have visual changes before a migraine starts, called a migraine aura . But these auras are less common in children than in adults.

Because behavior problems have been linked to migraines in some studies, you should look out for a headache combined with symptoms like irritability, changes in sleep or appetite, trouble at school, mood swings, restlessness, crying, withdrawing from friends or family, and lack of energy.

MINIMIZING MIGRAINES IN CHILDREN

"Causes of migraines in children are probably 60 to 70 percent genetic and 30 to 35 percent environmental, so you may not be able to prevent migraines," says Hershey. And, he says, though "migraine triggers are hard to identify and may be different for different children," there are some basic steps you can take, and they may also help prevent behavior problems related to migraines. He recommends that parents make sure their child:

- Drinks enough fluids. Dehydration is a common trigger- Avoids caffeine. Caffeine in soda or energy drinks may be a trigger. - Eats healthy foods and eats regularly. Skipping meals is also a common trigger.- Gets enough exercise. Exercise reduces stress, which could be a trigger.- Gets enough sleep. Most kids need nine hours or more.

Helping your child identify and avoid stress, depression, and anxiety can also help reduce migraines and behavior problems.

MIGRAINE RELIEF FOR CHILDREN

Treating migraines in kids may begin with a non-steroidal anti-inflammatory drug (NSAID) like Motrin or Advil. It's important to start treatment with these pain relievers at the first sign of a migraine. Migraine headaches that do not respond to NSAIDs may be treated with migraine-blocking medications called triptans . There are also migraine-prevention medications that may be used when migraines are very frequent.

"The goal of treatment is to limit migraines to one to two hours and decrease their frequency," says Hershey. "It is very important to not use narcotic medications. We don't want children to be isolated in a quiet, dark room — we want them to get treated and get back to their activities."

Migraine, depression, anxiety, and hyperactivity are all common in children. Until more is known about the link between behavior and migraine, the best thing to do is be aware of how your child is feeling and let your pediatrician know about any symptoms of headache or behavior problems.